More than 50 consumer and employer organizations have written an open letter to federal officials urging them to retain, in a final rule, the proposed definition for meaningful use of electronic health records.

"A final rule that does not lay a clear path in the first year toward tangible improvements in quality and lay the foundation for the systemic changes necessary for reform could waste taxpayer dollars and not launch us on the needed course for the future," according to the letter. It was sent April 20 to Kathleen Sebelius, secretary of the Department of Health and Human Services; Charlene Frizzera, acting administrator of the Centers for Medicare and Medicaid Services; David Blumenthal, M.D., national coordinator for health information technology within HHS; and Tony Trenkle, director of the Office of E-Health Standards and Services in CMS.

The organizations argue that industry assertions that the meaningful use criteria are a one-size-fits-all policy "do not reflect the reality of the thoughtfully balanced proposal." The proposed rule, they note, provides flexibility in enabling providers to choose the payment year they wish to start getting incentives yet still receive significant payments, a 90-day limit in the first payment year to demonstrate meaningful use, and varying thresholds across functional requirements.

The organizations further support recommendations of the HIT Policy Committee to enable providers to defer some functional criteria. "We do not, however, believe that this flexibility should include the ability to defer quality measurement, patient and family engagement, or privacy and security requirements," according to the letter. "Furthermore, this proposal should not be construed as a way to simply ease requirements in future years--any criteria that are deferred must be added to--and not serve in place of--new requirements in the succeeding payment year."

Health care has long lagged in its adoption of health information technology, an investment other industries view as simply a cost of doing business, the groups assert. The health care industry now has a significant opportunity to automate with unprecedented federal help. "As consumers and employers who pay for health care every day, we must see a return on this historic investment."

Robust meaningful use of EHRs will support aspects of the recently enacted health care reform law, the consumer and employer groups contend. "Delaying the foundational elements included in the robust proposed definition of meaningful use for 2011 will not only squander the golden opportunity provided by HITECH, but will also jeopardize the success of this Administration's bold work to reform our health care system. We urge you to maintain the clear path toward using HIT to improve outcomes that is reflected in the proposed rule."

Organizations signing the letter include AAPR; American Federation of State, County & Municipal Employees; Business Group on Health; CalPERS; Center for Democracy and Technology; Consumers Union, Families USA; National Business Coalition on Health; National Consumers League; National Retail Federation; Pacific Business Group on Health; SEIU; Leapfrog Group and Wal-Mart.

Text of the letter is available at

--Joseph Goedert


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